Skip to main content
Log in

Update on Staging and Surgical Treatment Options for Esophageal Cancer

  • 2011 SSAT Annual Meeting
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Introduction

Esophageal cancer remains a challenging clinical problem, with overall long-term survivorship consistently at a level of approximately 30%. The incidence of esophageal cancer is increasing worldwide, with the most dramatic increase being seen with respect to esophageal adenocarcinoma.

Discussion

Pretreatment staging accuracy has improved with the utilization of CT and PET scans, as well as endoscopic ultrasound and endoscopic mucosal resection. In an increasing percentage of patients, endoscopic techniques are being utilized in selected patients for the treatment of high-grade dysplasia in Barrett's and intramucosal cancer. Surgery remains the treatment of choice in all appropriate patients with invasive and locoregional esophageal cancer, although multimodality therapy is now used in most patients with stage II or stage III disease.

Conclusion

Outcomes for esophagectomy have been dominated by concerns regarding high mortality and morbidity; however, mortality rates associated with esophageal resection have dramatically decreased, especially in high-volume specialty centers. This manuscript highlights some of the evolutionary issues associated with staging and endoscopic and surgical treatments of Barrett's and esophageal cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Puli SR, Reddy JB, Bechtold ML, et al. Staging accuracy of esophageal cancer by endoscopic ultrasound: a meta-analysis and systematic review. World J Gastroenterol 2008;14:1479–1490.

    Article  PubMed  Google Scholar 

  2. Young PE, Gentry AB, Acosta RD, et al. Endoscopic ultrasound does not accurately stage early adenocarcinoma or high-grade dysplasia of the esophagus. Clin Gastroenterol Hepatol 2010;8:1037–1041.

    Article  PubMed  Google Scholar 

  3. Smith BR, Chang KJ, Lee JG, et al. Staging accuracy of endoscopic ultrasound based on pathologic analysis after minimally invasive esophagectomy. Am Surg 2010;76:1228–1231.

    PubMed  Google Scholar 

  4. Weber WA, Ott K. Imaging of esophageal and gastric cancer. Semin Oncol 2004;31:530–541.

    Article  PubMed  Google Scholar 

  5. Hayeck TJ, Kong CY, Spechler SJ, et al. The prevalence of Barrett’s esophagus in the US: estimates from a simulation model confirmed by SEER data. Dis Esophagus 2010;23:451–457.

    Article  PubMed  CAS  Google Scholar 

  6. Wang VS, Hornick JL, Sepulveda JA, et al. Low prevalence of submucosal invasive carcinoma at esophagectomy for high-grade dysplasia or intramucosal adenocarcinoma in Barrett’s esophagus: a 20-year experience. Gastrointest Endosc 2009;69:777–783.

    Article  PubMed  Google Scholar 

  7. Shaheen NJ, Sharma P, Overholt BF, et al. Radiofrequency ablation in Barrett’s esophagus with dysplasia. N Engl J Med 2009;360:2277–2288.

    Article  PubMed  CAS  Google Scholar 

  8. Schembre DB, Huang JL, Lin OS, et al. Treatment of Barrett’s esophagus with early neoplasia: a comparison of endoscopic therapy and esophagectomy. Gastrointest Endosc 2008;67:595–601.

    Article  PubMed  Google Scholar 

  9. Zehetner J, DeMeester SR, Hagen JA, et al. Endoscopic resection and ablation versus esophagectomy for high-grade dysplasia and intramucosal adenocarcinoma. J Thorac Cardiovasc Surg 2011;141:39–47.

    Article  PubMed  Google Scholar 

  10. Semlitsch T, Jeitler K, Schoefl R, et al. A systematic review of the evidence for radiofrequency ablation for Barrett’s esophagus. Surg Endosc 2010;24:2935–2943.

    Article  PubMed  Google Scholar 

  11. Banki F, Mason RJ, DeMeester SR, et al. Vagal-sparing esophagectomy: a more physiologic alternative. Ann Surg 2002;236:324–335.

    Article  PubMed  Google Scholar 

  12. Peyre CG, DeMeester TR. Vagal-sparing esophagectomy. Adv Surg 2008;42:109–116.

    Article  PubMed  Google Scholar 

  13. Ancona E, Rampado S, Cassaro M, et al. Prediction of lymph node status in superficial esophageal carcinoma. Ann Surg Oncol 2008;15:3278–3288.

    Article  PubMed  Google Scholar 

  14. Leers JM, DeMeester SR, Oezcelik A, et al. The Prevalence of Lymph Node Metastases in Patients With T1 Esophageal Adenocarcinoma: A Retrospective Review of Esophagectomy Specimens. Ann Surg 2011;253:271–278.

    Google Scholar 

  15. Pennathur A, Farkas A, Krasinskas AM, et al. Esophagectomy for T1 esophageal cancer: outcomes in 100 patients and implications for endoscopic therapy. Ann Thorac Surg 2009;87:1048–1054.

    Article  PubMed  Google Scholar 

  16. Sepesi B, Watson TJ, Zhou D, et al. Are endoscopic therapies appropriate for superficial submucosal esophageal adenocarcinoma? An analysis of esophagectomy specimens. J Am Coll Surg 2010;210:418–427.

    Article  PubMed  Google Scholar 

  17. Manner H, May A, Pech O, et al. Early Barrett’s carcinoma with “low-risk” submucosal invasion: long-term results of endoscopic resection with a curative intent. Am J Gastroenterol 2008;103:2589–2597.

    Article  PubMed  Google Scholar 

  18. Rice TW, Mason DP, Murthy SC, et al. T2N0M0 esophageal cancer. J Thorac Cardiovasc Surg 2007;133:317–324.

    Article  PubMed  Google Scholar 

  19. Medical Research Council Oesophageal Cancer Working Group. Surgical resection with or without preoperative chemotherapy in oesophageal cancer: a randomised controlled trial. Lancet 2002;359:1727–1733.

    Article  Google Scholar 

  20. Allum WH, Stenning SP, Bancewicz J, et al. Long-term results of a randomized trial of surgery with or without preoperative chemotherapy in esophageal cancer. J Clin Oncol 2009;27:5062–5067.

    Article  PubMed  Google Scholar 

  21. Gebski V, Burmeister B, Smithers BM, et al. Survival benefits from neoadjuvant chemoradiotherapy or chemotherapy in oesophageal carcinoma: a meta-analysis. Lancet Oncol 2007;8:226–234.

    Article  PubMed  CAS  Google Scholar 

  22. Courrech Staal EF, Aleman BM, Boot H, et al. Systematic review of the benefits and risks of neoadjuvant chemoradiation for oesophageal cancer. Br J Surg 2010;97:1482–1496

    Article  PubMed  CAS  Google Scholar 

  23. Berger AC, Scott WJ, Freedman G, et al. Morbidity and mortality are not increased after induction chemoradiotherapy followed by esophagectomy in patients with esophageal cancer. Semin Oncol 2005;32:S16–S20.

    Article  PubMed  Google Scholar 

  24. Low DE, Kunz S, Schembre D, et al. Esophagectomy--it’s not just about mortality anymore: standardized perioperative clinical pathways improve outcomes in patients with esophageal cancer. J Gastrointest Surg 2007;11:1395–1402.

    Article  PubMed  Google Scholar 

  25. Gaast AV, van Hagen P, Hulshof M, et al. (2010) Effect of preoperative concurrent chemoradiotherapy on survival of patients with resectable esophageal or esophagogastric junction cancer: Results from a multicenter randomized phase III study. J Clin Oncol 2010; 28:15s (suppl; abstr 4004)

    Google Scholar 

  26. Stahl M, Walz MK, Stuschke M, et al. Phase III comparison of preoperative chemotherapy compared with chemoradiotherapy in patients with locally advanced adenocarcinoma of the esophagogastric junction. J Clin Oncol 2009;27:851–856.

    Article  PubMed  CAS  Google Scholar 

  27. Swisher SG, Hofstetter W, Komaki R, et al. Improved long-term outcome with chemoradiotherapy strategies in esophageal cancer. Ann Thorac Surg 2010;90:892–898.

    Article  PubMed  Google Scholar 

  28. Burmeister BH, Smithers BM, Gebski V, et al. Surgery alone versus chemoradiotherapy followed by surgery for resectable cancer of the oesophagus: a randomised controlled phase III trial. Lancet Oncol 2005;6:659–668.

    Article  PubMed  Google Scholar 

  29. Stahl M, Wilke H, Fink U, et al. Combined preoperative chemotherapy and radiotherapy in patients with locally advanced esophageal cancer. Interim analysis of a phase II trial. J Clin Oncol 1996;14:829–837.

    PubMed  CAS  Google Scholar 

  30. Rizk NP, Venkatraman E, Bains MS, et al. American Joint Committee on Cancer staging system does not accurately predict survival in patients receiving multimodality therapy for esophageal adenocarcinoma. J Clin Oncol 2007;25:507–512.

    Article  PubMed  Google Scholar 

  31. Rizk NP, Seshan VE, Bains MS, et al. Prognostic factors after combined modality treatment of squamous cell carcinoma of the esophagus. J Thorac Oncol 2007;2:1117–1123.

    Article  PubMed  Google Scholar 

  32. Ariga H, Nemoto K, Miyazaki S, et al. Prospective comparison of surgery alone and chemoradiotherapy with selective surgery in resectable squamous cell carcinoma of the esophagus. Int J Radiat Oncol Biol Phys 2009;75:348–356.

    Article  PubMed  Google Scholar 

  33. Stahl M, Stuschke M, Lehmann N, et al. Chemoradiation with and without surgery in patients with locally advanced squamous cell carcinoma of the esophagus. J Clin Oncol 2005;23:2310–2317.

    Article  PubMed  Google Scholar 

  34. Miyata H, Yamasaki M, Takiguchi S, et al. Prognostic value of endoscopic biopsy findings after induction chemoradiotherapy with and without surgery for esophageal cancer. Ann Surg 2011;253:279–284.

    Article  Google Scholar 

  35. Birkmeyer JD, Siewers AE, Finlayson EV, et al. Hospital volume and surgical mortality in the United States. N Engl J Med 2002;346:1128–1137.

    Article  PubMed  Google Scholar 

  36. Kohn GP, Galanko JA, Meyers MO, et al. National trends in esophageal surgery--are outcomes as good as we believe? J Gastrointest Surg 2009;13:1900–1910.

    Article  PubMed  Google Scholar 

  37. van Lanschot JJ, Hulscher JB, Buskens CJ, et al. Hospital volume and hospital mortality for esophagectomy. Cancer 2001;91:1574–1578.

    Article  PubMed  Google Scholar 

  38. Meguid RA, Weiss ES, Chang DC, et al. The effect of volume on esophageal cancer resections: what constitutes acceptable resection volumes for centers of excellence? J Thorac Cardiovasc Surg 2009;137:23–29.

    Article  PubMed  Google Scholar 

  39. Hulscher JB, van Sandick JW, de Boer AG, et al. Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the esophagus. N Engl J Med 2002;347:1662–1669.

    Article  PubMed  Google Scholar 

  40. Omloo JM, Lagarde SM, Hulscher JB, et al. Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the mid/distal esophagus: five-year survival of a randomized clinical trial. Ann Surg 2007;246:992–1000.

    Article  PubMed  Google Scholar 

  41. Hulscher JB, van Lanschot JJ. Individualised surgical treatment of patients with an adenocarcinoma of the distal oesophagus or gastro-oesophageal junction. Dig Surg 2005;22:130–134.

    Article  PubMed  CAS  Google Scholar 

  42. Boone J, Livestro DP, Elias SG, et al. International survey on esophageal cancer: part I surgical techniques. Dis Esophagus 2009;22:195–202.

    Article  PubMed  Google Scholar 

  43. National Oesophago-Gastric Cancer Audit. An audit of the care received by people with Oesophago-Gastric Cancer in England and Wales. Third Annual Report 2010. The Information Centre. NHS. http://www.ic.nhs.uk/webfiles/Services/NCASP/audits%20and%20reports/NHS%20IC%20OGC%20Audit%202010%20interactive.pdf. Accessed Feb. 3, 2011.

  44. Chasseray VM, Kiroff GK, Buard JL, et al. Cervical or thoracic anastomosis for esophagectomy for carcinoma. Surg Gynecol Obstet 1989;169:55–62.

    PubMed  CAS  Google Scholar 

  45. Ribet M, Debrueres B, Lecomte-Houcke M. Resection for advanced cancer of the thoracic esophagus: cervical or thoracic anastomosis? Late results of a prospective randomized study. J Thorac Cardiovasc Surg 1992;103:784–789.

    PubMed  CAS  Google Scholar 

  46. Walther B, Johansson J, Johnsson F, et al. Cervical or thoracic anastomosis after esophageal resection and gastric tube reconstruction: a prospective randomized trial comparing sutured neck anastomosis with stapled intrathoracic anastomosis. Ann Surg 2003;238:803–812.

    Article  PubMed  Google Scholar 

  47. Urschel JD, Blewett CJ, Bennett WF, et al. Handsewn or stapled esophagogastric anastomoses after esophagectomy for cancer: meta-analysis of randomized controlled trials. Dis Esophagus 2001;14:212–217.

    Article  PubMed  CAS  Google Scholar 

  48. Blackmon SH, Correa AM, Wynn B, et al. Propensity-matched analysis of three techniques for intrathoracic esophagogastric anastomosis. Ann Thorac Surg 2007;83:1805–1813; discussion 1813.

    Google Scholar 

  49. Ercan S, Rice TW, Murthy SC, et al. Does esophagogastric anastomotic technique influence the outcome of patients with esophageal cancer? J Thorac Cardiovasc Surg 2005;129:623–631.

    Google Scholar 

  50. Behzadi A, Nichols FC, Cassivi SD, et al. Esophagogastrectomy: the influence of stapled versus hand-sewn anastomosis on outcome. J Gastrointest Surg 2005;9:1031–1040.

    Article  PubMed  Google Scholar 

  51. Watson TJ, DeMeester TR, Kauer WK, et al. Esophageal replacement for end-stage benign esophageal disease. J Thorac Cardiovasc Surg 1998;115:1241–1247.

    Article  PubMed  CAS  Google Scholar 

  52. Young MM, Deschamps C, Trastek VF, et al. Esophageal reconstruction for benign disease: early morbidity, mortality, and functional results. Ann Thorac Surg 2000;70:1651–1655.

    Article  PubMed  CAS  Google Scholar 

  53. Urschel JD, Blewett CJ, Young JE, et al. Pyloric drainage (pyloroplasty) or no drainage in gastric reconstruction after esophagectomy: a meta-analysis of randomized controlled trials. Dig Surg 2002;19:160–164.

    Article  PubMed  Google Scholar 

  54. Fok M, Cheng SW, Wong J. Pyloroplasty versus no drainage in gastric replacement of the esophagus. Am J Surg 1991;162:447–452.

    Article  PubMed  CAS  Google Scholar 

  55. Kent MS, Pennathur A, Fabian T, et al. A pilot study of botulinum toxin injection for the treatment of delayed gastric emptying following esophagectomy. Surg Endosc 2007;21:754–757.

    Article  PubMed  CAS  Google Scholar 

  56. Lagarde SM, Vrouenraets BC, Stassen LP, et al. Evidence-based surgical treatment of esophageal cancer: overview of high-quality studies. Ann Thorac Surg 2010;89:1319–1326.

    Article  PubMed  Google Scholar 

  57. Greenstein AJ, Litle VR, Swanson SJ, et al. Effect of the number of lymph nodes sampled on postoperative survival of lymph node-negative esophageal cancer. Cancer 2008;112:1239–1246.

    Article  PubMed  Google Scholar 

  58. Peyre CG, Hagen JA, DeMeester SR, et al. The number of lymph nodes removed predicts survival in esophageal cancer: an international study on the impact of extent of surgical resection. Ann Surg 2008;248:549–556.

    Article  PubMed  Google Scholar 

  59. Schwarz RE, Smith DD. Clinical impact of lymphadenectomy extent in resectable esophageal cancer. J Gastrointest Surg 2007;11:1384–1393.

    Article  PubMed  Google Scholar 

  60. Rizk NP, Ishwaran H, Rice TW, et al. Optimum lymphadenectomy for esophageal cancer. Ann Surg 2010;251:46–50.

    Article  PubMed  Google Scholar 

  61. Ferri LE, Law S, Wong KH, et al. The influence of technical complications on postoperative outcome and survival after esophagectomy. Ann Surg Oncol 2006;13:557–564.

    Article  PubMed  Google Scholar 

  62. Rizk NP, Bach PB, Schrag D, et al. The impact of complications on outcomes after resection for esophageal and gastroesophageal junction carcinoma. J Am Coll Surg 2004;198:42–50.

    Article  PubMed  Google Scholar 

  63. Wright CD, Kucharczuk JC, O’Brien SM, et al. Predictors of major morbidity and mortality after esophagectomy for esophageal cancer: a Society of Thoracic Surgeons General Thoracic Surgery Database risk adjustment model. J Thorac Cardiovasc Surg 2009;137:587–595.

    Article  PubMed  Google Scholar 

  64. Connors RC, Reuben BC, Neumayer LA, et al. Comparing outcomes after transthoracic and transhiatal esophagectomy: a 5-year prospective cohort of 17,395 patients. J Am Coll Surg 2007;205:735–740.

    Article  PubMed  Google Scholar 

  65. Swisher SG, Deford L, Merriman KW, et al. Effect of operative volume on morbidity, mortality, and hospital use after esophagectomy for cancer. J Thorac Cardiovasc Surg 2000;119:1126–1132.

    Article  PubMed  CAS  Google Scholar 

  66. Martin LW, Swisher SG, Hofstetter W, et al. Intrathoracic leaks following esophagectomy are no longer associated with increased mortality. Ann Surg 2005;242:392–399.

    PubMed  Google Scholar 

  67. Sarela AI, Tolan DJ, Harris K, et al. Anastomotic leakage after esophagectomy for cancer: a mortality-free experience. J Am Coll Surg 2008;206:516–523.

    Article  PubMed  Google Scholar 

  68. Kauer WK, Stein HJ, Dittler HJ, et al. Stent implantation as a treatment option in patients with thoracic anastomotic leaks after esophagectomy. Surg Endosc 2008;22:50–53.

    Article  PubMed  Google Scholar 

  69. Iannettoni MD, Whyte RI, Orringer MB. Catastrophic complications of the cervical esophagogastric anastomosis. J Thorac Cardiovasc Surg 1995;110:1493–1500.

    Article  PubMed  CAS  Google Scholar 

  70. Khuri SF, Henderson WG, DePalma RG, et al. Determinants of long-term survival after major surgery and the adverse effect of postoperative complications. Ann Surg 2005;242:326–341.

    PubMed  Google Scholar 

  71. Cerfolio RJ, Allen MS, Deschamps C, et al. Postoperative chylothorax. J Thorac Cardiovasc Surg 1996;112:1361–1365.

    Article  PubMed  CAS  Google Scholar 

  72. Merrigan BA, Winter DC, O’Sullivan GC. Chylothorax. Br J Surg 1997;84:15–20.

    Article  PubMed  CAS  Google Scholar 

  73. Lagarde SM, Omloo JM, de Jong K, et al. Incidence and management of chyle leakage after esophagectomy. Ann Thorac Surg 2005;80:449–454.

    Article  PubMed  Google Scholar 

  74. Itkin M, Kucharczuk JC, Kwak A, et al. Nonoperative thoracic duct embolization for traumatic thoracic duct leak: experience in 109 patients. J Thorac Cardiovasc Surg 2010;139:584–589.

    Article  PubMed  Google Scholar 

  75. van Goor AT, Kroger R, Klomp HM, et al. Introduction of lymphangiography and percutaneous embolization of the thoracic duct in a stepwise approach to the management of chylous fistulas. Head Neck 2007;29:1017–1023.

    Article  PubMed  Google Scholar 

  76. Atkins BZ, Shah AS, Hutcheson KA, et al. Reducing hospital morbidity and mortality following esophagectomy. Ann Thorac Surg 2004;78:1170–1176.

    Article  PubMed  Google Scholar 

  77. Kinugasa S, Tachibana M, Yoshimura H, et al. Postoperative pulmonary complications are associated with worse short- and long-term outcomes after extended esophagectomy. J Surg Oncol 2004;88:71–77.

    Article  PubMed  Google Scholar 

  78. Law S, Wong KH, Kwok KF, et al. Predictive factors for postoperative pulmonary complications and mortality after esophagectomy for cancer. Ann Surg 2004;240:791–800.

    Article  PubMed  Google Scholar 

  79. Dumont P, Wihlm JM, Hentz JG, et al. Respiratory complications after surgical treatment of esophageal cancer. A study of 309 patients according to the type of resection. Eur J Cardiothorac Surg 1995;9:539–543.

    Article  PubMed  CAS  Google Scholar 

  80. Lin FC, Durkin AE, Ferguson MK. Induction therapy does not increase surgical morbidity after esophagectomy for cancer. Ann Thorac Surg 2004;78:1783–1789.

    Article  PubMed  Google Scholar 

  81. Dhungel B, Diggs BS, Hunter JG, et al. Patient and peri-operative predictors of morbidity and mortality after esophagectomy: American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), 2005–2008. J Gastrointest Surg 2010;14:1492–1501.

    Article  PubMed  Google Scholar 

  82. Berry MF, Atkins BZ, Tong BC, et al. A comprehensive evaluation for aspiration after esophagectomy reduces the incidence of postoperative pneumonia. J Thorac Cardiovasc Surg 2010;140:1266–1271.

    Article  PubMed  Google Scholar 

  83. Kita T, Mammoto T, Kishi Y. Fluid management and postoperative respiratory disturbances in patients with transthoracic esophagectomy for carcinoma. J Clin Anesth 2002;14:252–256.

    Article  PubMed  Google Scholar 

  84. Tsui SL, Law S, Fok M, et al. Postoperative analgesia reduces mortality and morbidity after esophagectomy. Am J Surg 1997;173:472–478.

    Article  PubMed  CAS  Google Scholar 

  85. Chang LC, Oelschlager BK, Quiroga E, et al. Long-term outcome of esophagectomy for high-grade dysplasia or cancer found during surveillance for Barrett’s esophagus. J Gastrointest Surg 2006;10:341–346.

    Article  PubMed  Google Scholar 

  86. Headrick JR, Nichols FC, III, Miller DL, et al. High-grade esophageal dysplasia: long-term survival and quality of life after esophagectomy. Ann Thorac Surg 2002;73:1697–1702.

    Article  PubMed  Google Scholar 

  87. Moraca RJ, Low DE. Outcomes and health-related quality of life after esophagectomy for high-grade dysplasia and intramucosal cancer. Arch Surg 2006;141:545–549.

    Article  PubMed  Google Scholar 

  88. Parameswaran R, Blazeby JM, Hughes R, et al. Health-related quality of life after minimally invasive oesophagectomy. Br J Surg 2010;97:525–531.

    Article  PubMed  CAS  Google Scholar 

  89. Fernando HC, Murthy SC, Hofstetter W, et al. The Society of Thoracic Surgeons practice guideline series: guidelines for the management of Barrett’s esophagus with high-grade dysplasia. Ann Thorac Surg 2009;87:1993–2002.

    Article  PubMed  Google Scholar 

  90. Tseng EE, Wu TT, Yeo CJ, et al. Barrett’s esophagus with high grade dysplasia: surgical results and long-term outcome--an update. J Gastrointest Surg 2003;7:164–170.

    Article  PubMed  Google Scholar 

  91. Reed MF, Tolis G, Jr., Edil BH, et al. Surgical treatment of esophageal high-grade dysplasia. Ann Thorac Surg 2005;79:1110–1115.

    Article  PubMed  Google Scholar 

  92. Sujendran V, Sica G, Warren B, et al. Oesophagectomy remains the gold standard for treatment of high-grade dysplasia in Barrett’s oesophagus. Eur J Cardiothorac Surg 2005;28:763–766.

    Article  PubMed  Google Scholar 

  93. Rice TW. Pro: esophagectomy is the treatment of choice for high-grade dysplasia in Barrett’s esophagus. Am J Gastroenterol 2006;101:2177–2179.

    Article  PubMed  Google Scholar 

  94. Williams VA, Watson TJ, Herbella FA, et al. Esophagectomy for high grade dysplasia is safe, curative, and results in good alimentary outcome. J Gastrointest Surg 2007;11:1589–1597.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Donald E. Low.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Low, D.E. Update on Staging and Surgical Treatment Options for Esophageal Cancer. J Gastrointest Surg 15, 719–729 (2011). https://doi.org/10.1007/s11605-011-1515-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11605-011-1515-9

Keywords

Navigation